A recent study published in the Orapuh Journal (Vol. 5, No. 7, December 2024) has spotlighted critical inefficiencies in operating theatre (OT) management at a Nigerian teaching hospital. Authored by Akpanudo, E. I., Ituen, M. A., and Iyanam, V. E., from the University of Uyo, Uyo, Nigeria, the study underscores the need for improved resource allocation and process optimisation in Nigerian healthcare.

Study Overview

The research evaluated Operating Theatre (OT) time utilisation and elective surgery cancellations over a one-month period. The analysis focused on factors such as first-case tardiness, prediction bias, turnover time, and cancellation rates, using a prospective cross-sectional design. The findings paint a sobering picture of systemic inefficiencies that hinder patient care.

Key Findings

  • Surgical Cancellations: Out of 133 scheduled surgeries, a staggering 44.4% (59 surgeries) were cancelled. Patient non-attendance (33.9%) and time constraints (27.1%) emerged as the top reasons for cancellations.
  • OT Utilisation: Raw OT utilisation stood at 55.4%, with general surgery recording the highest utilisation at 81.5%.
  • Delays: The mean first-case tardiness was 133.7 ± 46.4 minutes, while prediction bias averaged 49.9 ± 44.3 minutes. These factors significantly impacted OT utilisation (B = -0.219, p = 0.007; B = 0.305, p = 0.005, respectively).
  • Lost Time: Delayed starts resulted in 5,886 minutes of wasted OT time, highlighting a dire need for workflow improvements.

Implications for Healthcare

The study emphasises the importance of optimising OT processes in resource-constrained healthcare systems like Nigeria’s. Underfunding and inefficiencies not only limit surgical care but also increase the cost burden on hospitals and patients.

Proposed Solutions

To address these challenges, the authors recommend:

  1. Enhanced Patient Communication: Introducing financial counselling and automated reminders to reduce patient no-shows.
  2. Digital Scheduling Tools: Leveraging technology to improve scheduling accuracy and minimise prediction bias.
  3. Workflow Standardisation: Streamlining OT processes to reduce delays and increase utilisation rates.

A Call to Action

With healthcare systems globally grappling with resource constraints, this study reinforces the need for data-driven interventions to maximise efficiency. The authors urge policymakers and hospital administrators to prioritise investments in operational audits and digital tools to enhance surgical care delivery.

This research offers a critical roadmap for improving OT efficiency, ensuring equitable access to surgical care, and advancing Nigeria’s healthcare infrastructure.

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